螺旋CT泪道造影在鼻眶筛骨折后泪道阻塞中的应用  

The assess of spiral CT dacryocystography in the diagnosis of lacrimal pathway obstruction after naso-orbital-ethmoid fracture

作　　者：艾松涛[1] 潘懿范[2] 肖彩雯[3] 范先群[3] 陶晓峰[1] 范新东[1] 

机构地区：[1]交通大学医学院附属第九人民医院放射科,上海200011 [2]交通大学医学院附属第九人民医院核医学科,上海200011 [3]交通大学医学院附属第九人民医院眼科,上海200011

出　　处：《放射学实践》2013年第4期387-389,共3页Radiologic Practice

摘　　要：目的:探讨螺旋CT泪道造影在鼻眶筛骨折后泪道阻塞中的应用价值。方法:搜集33例鼻眶筛骨折后出现泪道阻塞症状≥6月并行薄层CT泪道造影的患者的CT资料,所有CT资料均经过薄层多平面重组(MPR)后处理,分析泪道系统骨折情况及骨性结构,比较骨折后泪道各部位阻塞的发生率。结果:骨性泪道最易发生骨折的部位位于鼻泪管内侧壁(54.84%)及泪后嵴(51.61%)。鼻眶筛骨折后阻塞部位在泪囊与鼻泪管连接处水平的所占比例最大(33.33%,14/42),在鼻泪管上段水平的次之(28.57%,12/42)。正常侧与患侧鼻泪管的矢状面夹角的差异有统计学意义(t=-3.43,P=0.0023),正常侧与患侧鼻泪管的水平面夹角差异无统计学意义(t=-2.06,P>0.05)。结论:螺旋CT泪道造影经多平面重组技术能清楚显示鼻眶筛骨折后泪道系统的骨性结构及泪道阻塞情况,对于鼻眶筛骨折性泪道阻塞的手术治疗具有十分重要的价值。Objective：To assess the value of spiral CT dacryocystography in the diagnosis of lacrimal pathway ob- struction after naso-orbital-ethmoid fracture. Methods： 33 patients had clinical symptoms of dacryo-stenosis for more than 6 months after naso-orbital-ethmoid （NOE） fracture underwent spiral CT dacryocystography with multi-planer reformation （MPR） ,the images were analyzed. The fractures and bony structures of lacrimal pathway were assessed, and the incidence of various obstruction position of lacrimal system was evaluated and analyzed. Results：The medial wall of nasolacrimal duct （54. 84%） and posterior lacrimal crest （51.61%） were the commonest position of fracture of lacrimal system. The majority of obstruction after NOE fracture was at the junction of lacrimal sac and nasolacrimal duct （33.33 %,14/42）, and the sec- ond predilection site of obstruction was the upper segment of nasolacrimal duct （28. 57%, 12/42）. There was significant difference between the angle formed by the sagittal plane and the axis of nasolacrimal duct of injured side compared with that of the normal （t =- 3. 43, P = 0. 0023）. On the other hand, there was no significant difference between the angle formed by the axial plane and normal/injured side of nasolacrimal duct （t=-2.06 ,P〉0. 05）. Conclusion：The bony struc- ture and obstruction of lacrimal system could be clearly assessed by spiral CT dacryocystography with MPR post-processing technique,which is very valuable in surgical treatment of lacrimal obstruction after NOE fracture.

关 键 词：鼻眶筛骨折 泪道阻塞 体层摄影术 X线计算机 泪道造影 

分 类 号：R816.96[医药卫生—放射医学]